Both service providers (health practitioners) and plan members receive convenient, paperless claims service while providing streamlined claims adjudication and more environmentally friendly service.
Students will appreciate the convenience of eClaims, which allows for submitting healthcare claims through a secured online service. Online claim submission is available for a variety of covered healthcare services, such as prescription drugs, dental care, vision care and paramedical services. To take advantage of eClaims, students must be registered on the insurer’s member site for Direct Deposit of claim payments and eDetails to notify them by e-mail when a claim has been processed and the claim details are available online.
Expanding on the dental-style electronic claim submission, Provider eClaims allows for providers who have joined the electronic provider network to submit claims electronically at the point of sale for students. Claims are adjudicated automatically, with checks on coverage, the types of expenses claimed and provider eligibility. Service providers receive immediate notice of the result of initial adjudication to share with the students, indicating the claim has been approved, declined or held for review.